First State Technical Assistants Biannual Meeting, 5-8 November 2015

EU-SIGN has State Technical Assistants (STA) in the 23 EU-SIGN States and the FCT. The STAs work with the State Primary Health Care Development Agencies or Ministries of Health to implement activities and support policies to strengthen routine immunisation and primary health care in the States. They are key to EU-SIGN’s success.

From L-R are Dr Anne McArthur - TA Consortium from HPI), Dr MZ Mahmud (standing) - Director Logistics and Health Commodities, Aminata Sidibe - Training Contracting Advisor and Procurement Expert - and Dr Sofo Ali - Short-term Expert in Public Health during the Opening
From L-R are Dr Anne McArthur – TA Consortium from HPI), Dr MZ Mahmud (standing) – Director Logistics and Health Commodities, Aminata Sidibe – Training Contracting Advisor and Procurement Expert – and Dr Sofo Ali – Short-term Expert in Public Health during the Opening

The first Bi-annual Review Meeting for the STAs and their State counterparts was held in Abuja from 5-8 November. Representatives of major stakeholders (NPHCDA, MBNP, EUD, WHO, McKinsey & Company, CHAI, IVAC, UNICEF) attended all or parts of the meeting.

The Bi-annual meeting was an excellent opportunity to review the goals and objectives of the project’s second Operation Programme Estimate (OPE2); to review performance on routine immunisation and Primary Health Care Under One Roof in the States; and to review milestones, indicators and reporting tools. Dr. Attah, the EU-SIGN Immunisation Expert and Dr. Daniel Ali of WHO demonstrated several of the key immunisation monitoring and vaccine management tools and answered questions and provided clarifications.

Dr A. D Dawud, the National Focal Person for EU-SIGN, concluding his presentation
Dr A. D Dawud, the National Focal Person for EU-SIGN, concluding his presentation

Short-term Technical Experts (STEs) in Public Health and Monitoring and Evaluation (M&E) attended the meeting and presented on their recent work on community engagement, working with Civil Society and on the new EU-SIGN M&E strategy.

Several States prepared presentations on activities in their States and provided guidance to other States facing similar situations and challenges.

The fourth day of the workshop focused largely on administrative and financial issues and State Financial Officers joined the workshop. Mrs. Aminata Sidibe, Training and Contracting Advisor / Procurement Expert led an interactive session on OPE2 financial procedures and was able to answer participants’ questions on timesheets, debit note preparation and other issues. Team Leader, Dr. Lamiri reviewed job descriptions and expectations and also answered questions on procedures, challenges and solutions for successful implementation in the States.

The Team Leader, Dr Goli Lamiri, and Training Contracting Advisor and Procurement Expert, communing to resolve numerous questions arising from the presentation
The Team Leader, Dr Goli Lamiri, and Training Contracting Advisor and Procurement Expert, communing to resolve numerous questions arising from the presentation

The conduct of the first STA Biannual Meeting Review was, no doubt, a huge success based on full attendance, level of participation, presentation of all planned topics, understanding as revealed from evaluation reports/results of each session with corresponding score of over 70%. The strategic direction provided by the approved OPE2, will enhance the quality and speed of Project implementation at State and LGA levels.

The first day of the meeting received significant media coverage. The following clip from Channels Television provides an overview of the project and the meeting.

https://www.youtube.com/watch?v=tTi6lcjVSBg

NPHCDA and EU-SIGN Meeting on Operations Research and the Establishment of an Operations Research Advisory Committee

lagos_L3The third result area of the EU-SIGN project is to improve information and knowledge generation for Routine Immunisation, which includes supporting Operations Research (OR) to inform and drive policy, planning and programme implementation.

EU-SIGN supported a meeting in Lagos from 28-29 October 2015 to define the National Primary Health Care Development Agency (NPHCDA) research priorities and harmonise all research efforts of the different technical departments of the NPHCDA under the Operations Research (OR) Unit of the Department of Planning Research and Statistics (DPRS).

The meeting was presided over by Dr. Urua (Head of OR of NPHCDA) and participants included Representatives from the ED/CEO of NPHCDA, SWZ Coordinator, Dr. Olayinka Oladimeji, NPHCDA Staff, representative of Permanent Secretary (PS) LSPHCDB, Dr. F. O. Sanni, DPRS (LSMoH) and EU-SIGN TA team (Team Leader and Immunisation Expert).

From L-R are Dr Goli, Mr Jeff Mecaskey and Dr James Attah at the Lagos Operations Research meeting, 28-29 July 2015
From L-R are Dr Goli, Mr Jeff Mecaskey and Dr James Attah at the Lagos Operations Research meeting, 28-29 October 2015

To manage the different OR studies and to avoid duplication of efforts and research, an Operational Research Advisory Group (ORAG) was inaugurated at the meeting, with the NPHCDA taking a critical leadership role to shape a OR strategy. This earlier inauguration of ORAG and outcome of this meeting is one of the biggest legacies of the EU-SIGN project.

Other major achievements resulting from this meeting include:

  • The OR Research Unit of NPHCDA has been empowered as the centre for co-coordinating all research in NPHCDA to avoid duplication and to improve efficient use of resources.
  • The ORAG agreed to kick-start research proposal development with key timelines and responsible persons/bodies.
  • EU-SIGN strategic objective in contributing to positioning NPHCDA for OR was clearly outlined.
  • A draft work plan for OR was developed by the OR Unit of DPRS of the NPHCDA pursuance of the resolutions reached during the Lagos meeting.

Recommendations include:

  •  The DPRS should continue to pursue the NPHCDA research agenda as the leading agency in public health research.
  • NPHCDA should create a special fund for research purposes.
  • All partners should discourage segmentation of research through avoidance of vertical approach.
  • All stakeholders, especially ORAG members should support the nascent body (ORAG) to provide the strategic direction for the NPHCDA research agenda.

December 2015: EU-SIGN Advocacy Meetings on the Implementation of Primary Health Care (PHC) Under One Roof in Kano and Anambra States

Advocacy is an important part of EU-SIGN’s mandate to promote the importance of routine immunisation and also to encourage the strengthening of Primary Health Care Under One Roof (PHCUOR) in the EU-SIGN States.

In December 2015, EU-SIGN conducted two advocacy visits – one to Kano State and the second to Anambra State. The project was represented by Dr. Dawud of the NPHCDA; Mr. Adesina and Dr. Eboreime of the Department of Planning Research and Statistics of the NPHCDA; and Dr. Attah, EU-SIGN Immunisation Expert. During the visit, the team met with key Government and partner stakeholders to assess the implementation of the PHCUOR, ensure EU-SIGN commitment to the State Primary Health Care Development Agencies, and to inform each of the States of EU-SIGN technical and equipment support to the State programme.

Kano State, 7 December 2015

A1
Kano : Presentation of objectives by Dr. James Onoja Attah, EU-SIGN Immunisation Expert

In Kano State, Dr. Sharif Y. Musa, Director of Epidemiology and Disease Control/State Immunisation Officer represented the Executive Secretary, Dr. Mohammed Nasir Mahmoud and opened the meeting, which was also attended by Directors from the Local Government service commission, WHO, UNICEF and CHAI. The meeting participants discussed some of the challenges in achieving a higher score on PHCUOR implementation, but a plan was developed to address governance, system, human resources, funding and EU-SIGN office set-up.

The team also briefed the Honorable Commissioner of Health on areas of concern and to update him on the progress of EU-SIGN in Kano State.

The event was covered in the press (Radio Kano, NTA and FRCN) and in the Daily Trust.

http://www.dailytrust.com.ng/news/kano-chronicles/kano-to-benefit-8-1-million-euro-from-eu-sign/128279.html

Anambra State, 11 December 2015

Anambra State committed to establishing its State Primary Health Care Development Agency (SPHCDA) in June 2015

Anambra: The Honorable Commissioner of Health, Dr. Joe Akabuike, delivering his address during the meeting
Anambra: The Honorable Commissioner of Health, Dr. Joe Akabuike, delivering his address during the meeting

and has been active in strengthening PHCUOR. Anambra’s PHCUOR score has increased from 7% in 2014 to 54% in October 2015, with the strong support of Anambra State Governor, Dr. Willie Obiano and the Honorable Commissioner of Health, Dr. Joe Akabuike. The Executive Secretary, Dr. Mrs. Chioma Ezenyimulu presented on the progress of Anambra State.

The EU-SIGN team updated the team on the status of EU-SIGN implementation, procurement and support in Anambra and followed-up on a road map that was established in June 2015 towards improvements in PHCUOR.

Anambra State has strong political will and cooperation to support PHCUOR, but challenges remain to the full establishment of the SPHCDA (transfer of staff, legal challenges, Minimum Service Package to be drafted) but the team is committed to addressing the issues and working together with partners to move the SPHCDA forward.

 

Brief on the Operational Programme Estimates (OPEs)

Previous Programme Estimates:

  1. Start Up Programme Estimate (SUPE): 15 May 2013 – 14 November 2013 (6 Months)
  2. First Operational Programme Estimate (OPE1): January 3, 2014 – July 2, 2015 (18 months)
  3. Proposed Operational Programme Estimate (OPE2): July 3, 2015 – October 2, 2016 (5 months)

Context of OPE2

  • National Health Bill Passed
  • Supporting SPHCDAs function is paramount – related the EU-SIGN’s role to increase eligibility of States to benefit
  • GAVI Transition

Opportunities

  • Bill and Melinda Gates Foundation
  • Other Partners CHAI, McKinsey, Dangote, DFID, USAID, UN
  • NPHCDA and NPC huge commitment and support

OPE1 Accomplishments

  • Built on gains made in PHC and RI in support of PHCUOR and the National Routine Immunisation Strategic Plan (NRISP) by NPHCDA – improvement of cold chain capacity and vaccine supply (PUSH)
  • Integrated supportive supervision has been scaled up nation-wide; partner coordination is strong
  • Nigeria has successfully introduced pentavalent vaccine nation-wide and is phasing in pneumococcal vaccine (PCV) and Inactivated Polio Vaccine (IPV)
  • The number of States having State Primary Health Care Development Agency (SPHCDA) is increasing
  • The TAT has been integrated into all RI Technical Working Groups at national and 23 States and FCT.

Coverage and Scale Up of Interventions in OPE2

  • The technical activities planned for implementation in OPE2 tailored in majority of instances for full coverage of the 23 focal States and FCT, all the LGAs and in 30-50% political wards targeted based on EU equipment sites (1,048 sites where the project is supplying direct solar drive refrigerators, other cold chain equipment and transport).

Key Activities under OPE2 include:

  • Support the establishment of SPHCDAs in states where they are none existent (Anambra, Ebonyi, Edo, Akwa Ibom, Cross River, Plateau and Osun States). The STAs, with technical guidance from the TAT, will be supporting the states technical team in the development of Bills that will be sent to the States’ Houses of Assembly for this purpose. The STAs will advocate and follow-up with relevant bodies and officers to ensure that this bill is passed by the State House of Assembly (SHA) and assented to by the State Government for implementation.
  • Identify and strengthen the weak areas of PHCUOR 9 pillars for sustainability, efficiency and effectiveness. This will be the main activities for the SPHCDAs since 18 EU-SIGN States (75% administrative data) have established SPHCDA. It is therefore important to note that the greatest challenge or workload for OPE2, unlike OPE1, is not that of establishment but strengthening the SPHCDA and sustaining its functionality.
  • Build management capacity of PHC Managers at the SPHCDA to strengthen planning, organisational, quality of care, budgeting skills and social accountability
  • Support national and states to hold biannual or quarterly health (PHC/RI) reviews on the performance and functionality of the Zonal Health Boards shall be carried out and funded by the States
  • Improve management practices through mentoring and on-the-job training
  • Improve data quality, decision making, prioritisation, performance monitoring and accountability
  • Providing IT infrastructure as an enabler for a scale up of DHIS (District Health Information System) within the National Health Information System
  • Ensuring reliable and sufficient funding for immunisation operational funds.